4090 Oakbrooke Alcove
Use BLUE or BLACK Ink
For Office Use
Permit
City f Ea aO I Permit Fee: I
3830 Pilot Knob Road I T
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I 1
Fax: (651) 675-5694 I Staff: I
I
2010 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: ( /~~Z~7~/a Site Address:
Tenant: X 0v~ TT- Suite
RESIDENT/ OWNER Name: 1647- Phone:
Address / City / Zip: Z 0, yrc'
Applicant is: 4 Owner Contractor
TYPE OF WORK Description of work: /"G rln
101
ov
Construction Cost: /D, Multi-Family Building: (Yes / No 4-)
CONTRACTOR Name: r~-rLG~i d~ License ,p lvY9a Z
Address: /S'(o ,~!l~ /martZ'd City:/rst
State: A41f11 Zip: a y?~~ Phone:
Contaci:._-~ 171 Email: 7~-,,,4-1 C'
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www._qopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
x
Applicant's Printed Name Applicant's Signature
Page 1 of 2
BiIRN,SVILLE
Heating & Air Conditioning, L.L.C.
12481 Rhode Island Ave S, Sav¢gg MN 55378 • 952-894-0005
Orsht Test Report for Job# 3/ z 3
AddreSS City
Occuoant rZ I 4 ?
Date af Install dl ?a? la z
Type of HT. F/A ?% NW Space HT.
Make ( P k ^ c v-
Model K,-26Q3-2? ?
Serial
Input
Pilot Type _
Pressure _
Input CFH _
Stack Temp
HOT SURFACE IGNlTOR
kc
Unit HT
C02 t 7
02
CO c
DateTested 7 12 "7
Company.
Technician
BURNSVILLE HEAT/NG & AlR CONDITIONING
'I L
'Lv} \a 131 k ` IESIDENTIAL 6f y gay9
C}ak6(00keV?, BUILDINC PERMIT APPLICATION 1't1lP y9aso
CITY OF EAGAN I' I? ?I ?..25 I
8830 PILOT KNOB RD - 55122
? • G,?.?y,?? 651-681-4675
New nsLUCt R ui men?1 •Pa RemodellReoairReauiremeMS • 3 registered sile surveys showing sq. R W bt, sq. of Iwuse; an II roofed areas ? a"3 9 ? • 2 copies of PWn
(20% maximum bt cwerage allaved) . 1 set of Energy CalaWtions for heated additions
• 2 copies of plan shawing beam 8 wintlow sizes; poured tound design, etc.) • t site survey for exterior additions 8 decks
• 1 set ot Eneryy Calr la5ons
• 3 apies of Tree Preservation Plan "rf lot platted afler 711193
• Rim Joisl Detal OpOOns selection sheet (bldgs wiUi 3 w less uniCS)
DATE
VALUATION (EXCLUDING LAND)
-Ll°r?3 ? I
'7o,so
9b?so
l1-'D __7 -C) (
.iJB SITE ADDRESS `r0 Sv Oc.U.kzrvokc. 414_oue.
IF MULTI-fAMILY BUILDING, HOW MANY UNITS? /vIA
PROPERTY OWNER Pu I,k- llo...rs -54 /1'lN 6,12
TYPE OF WORK /1/e,,, Co., st?uoG?o., fIREPLACE(S) _0 Xl _2 _3
APPLICANT )P-/s4, "ow.. s o? /31i1/ Cor.o PHONE# rf Is)'/S1-SZOv
ADDRESS glS Nortt c„tict f'cYrkw? s?.'•? ?YO ZIPCODE
PAGER # CELL PHONE # FAX #
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1
(check one) - Residential VentilaGon Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
? MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
' Plumbing Contractor. V a PIu ,.( L) ti?3 Phone #: Ia S I "qY.2 f a) 2 J
Plumbing System Include? Water Softe eiS r _ Lawn Sprinkler Fee: $90.00
ZC Water Heater ? No. of R.I. Baths
3 No. of Baths
Mechanicai Contractor: 1-3u r N s U: Itc, /-c4 k1v. t, Phone # c
? 5,2l 'P y- Uo 0 5'
Dlechanical S}stem Includes: Air Conditionin; Fee: $70.00
Heat Recovery System
Sewer/WaterControctor. 6-?a.r?1 ypt_ -kro Phone# ?(a/y.2d'•r??/%?
All above information must be submitted prior to processing of application. '?"d V I'S ?l i
I hereby ocknowledge that I have read this application, state that the informati? s correct, gr complywith
all applicable State of Minnesota Statutes and City of Eagan Ordinances. -
r-?
Signature of Appiicant
Certificates of Survey Received Tree Preservation Plan Received _ Not Required ?
UpdatEd 1/07
OFFICE USE ONLY
? 01 FoundaGon
02 SF Dwelling
? 03 01 of _ plex
? 04 02-plex
? 05 03-plex
? 06 04-plex
? 07 05-plex ? 13 16-plex
? OB 06-plex ? 16 Fireplace
13 09 07-plex ? 17 Garage
? 10 08-plex ? 18 Deck
O 11 10-plex ? 19 Lower Level
? 12 12-plex Plbg_Y or _ N
REQUIRED IjdSPECTIONS
_L?' FinaUC.O.
? 20 Pool
? 21 Porch (3-sea.)
? 22 Porch/Addn. (4-sea.)
? 23 Porch(screened)
? 24 Storm Damage
? 25 Miscellaneous
x 31 New ? 35 Int Improvement ? 38 Demoiish (Interior) O 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
0 33 Alteratlon O 37 Demolish (Bldg)' O 43 Reroof ' ? 46 WindowslDoors
D 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy /I - 3 MC/ES System
Census Code Zoning p 67 City Watei ?
SAC Units Stories A Booster Pump
Nbr. of Units o? Sq. Ft. /6 PRV ??
Nbr. of Bldgs ol Length ? a- Fire Sprinklered
Type of Const V;V Width V
? Footings (new bldg)
_ Footings (deck)
Footings (addition)
_k,'-Foundation
?Drain Tile
Roof Ice & Water Final
?Framing
L,-"?Fireplace R.I. Air Test Final
1,,*'Insulation
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
_ FinaUNo C.O.
_ Plumbing
_ HVAC
? 30 Accessory Bldg
? 31 Ext. Alt- Multi
? 33 Ext. AIt - SF
0 36 Multi
; . .
e
_ Other y
_ Poo] _ Ftgs _ Air/Gas Tesu _ Final
_ Siding SNcco Srone
_ Windows (new/replacement)
Approved By Building Inspector ?
---------------------------------z???=??`-?---? -------
l3SMY •
/69,) x /"5 °? - /63&0
?/?7oT? LvL
,??p rc/L
!n 03 x54= ?y 5 'r /cI
C12/1-/13 /L
41 ?h'X 16?' = 77y?
pviLJ ??or" /rcc??,?p2c?
?'O 7-J91- l 3 ? A 5 f
Address 409 (1 Oa k h r n n k a A 1 r n v P Zlp $5122
I.ot ? Blk s Sub
Oakbracke Sth
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION.
Date: Qa Yes No Inspector: r
Fina] grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry)
Permanent driveway
Permanent gas
Sod/Seeded gtass
TraiUcurb damage
?.
Porch V/
Basement finish
Deck
Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water suppiy to
the oufside lawn faucet before freeze potential exists.
Contact engineering division at 681-4645 before working in rightof-way or installing underground sprinkler system. ?
White - City Copy Yellow - Resident Copy Pink - Contraclor Copy
2005 RESIDENTIAL BUILDING PERMIT APPLICATION
9 ^-1 City OF Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675 FAX # 651-675-5694
a -7 C.O 3
New Construction ReauiremenLS RemodeUReoairReauirements Offlce Use OnN
3 registered stte surveys showing sq. ft. of lol, sq. R of house; and all roofed areas 2 wpies of plan CeR of Survey Recd _ Y_ N
(20% maximum lot coverage allaxed) 1 set of Energy CalculaCrons for heated additiore Tree Pres Plan Recd _ Y_ N,
2 copies of plan showing beam 8 window s¢es; poured found design, etc. 1 site survey for addiGOns & decks Sree PreslRequired _ Y_ N
i sel of Energy Calculations Add'Non - indicafe ilon-site seplic sysfem Onsile.Septic System _ Y_ N
3 copies of Tree Presenation Plan if lot platted after 711/93
Rim Joist Detaa Options selection sheet (buJdings with 3 or less unifs)
Date 4 /
Site Address k / 1,&o b
41 o-<k) pc.?'?r- ?,.oo k Construction Cost ?75-aa
. A-(,r_?? Uniuste #
Description ot Work -QZ_4,L
Multi-Family Bld g _ Y ]lN Fireplace(s) _ 0 _ 1 _ 2
Property Owner -g?'ar Telep6one # ( LS)) (0$7 -`17 '1LI
Cootractar `?N :?L
Address
State Z-o,. S-,7, ?3 wAti
?''"?v ?+4-. A"'t--
Zip Z? City
`
Telephone#('CGZ) S10 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Minnesota Rules 7690 Cate¢orv 1 Minnesota Rules 7672
Enefgy Code Category , Residential Ventilation Category 1 Worksheel • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitled
• Energy Envelope Calculations Submitted
Have you previously consiructed a building in Eagan with a similar plan2 _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanicai Contractor
Sewer/Water Contractor
Telephone #(
Telephone #(
Telephone #(
I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a permit, but only an application for a permit, and wor ' ' t a
eLY'??
permit; that the work will be in accordance with the approved plan in the case of work w ?r44
approval of plans. ?
? APR o 4 2005 ? i
? w
ApplicanYs PriName Applicant's Signa e !Ry
OFFICE USE ONLY
Sub Types
,_ .
O Ot Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 AccessoryBldg
? 02 SF Dwelling ? OB 06-plex O 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 08-plex F 18 Deck ? 23 Porch (screen/gazebo) ? 36 MuRi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex O 12 12-plex Pibg_Y or _ N ? 25 Miscellaneous
Work Types
(gP 31 New
( ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
0 33 Alteration ? 37 Demolish 8uilding* O 43 Reroof O 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code 43Y Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# of Bldgs Length Fire Sprinklered
Type of Const Width
Footings (new bldg)-
? Footings(deck)
_ Footings (addition)
Foundation
Drain Tile
Roof [ce & Water Final
_ Framing
_ Fireplace _ R.I. _ Air Test _ Final
_ Insulation .
Approved By:
REQUIRED INSPECTIONS
_ FinaVC.O.
? FinaVNo C.O.
_ Plumbing
HVAC
Other
_ Pool _ Ftgs _ Air/Gas Tests Final
_ Siding _ Stucco _ Stone _ Brick
_ Windows
_ Retaining Wall
Building Inspector
Base Fee
Surcharge
Pian Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
• Surveyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED As :Lot 2, Block 3, OAKBROOKE 5TH ADDIION, City of Eagan, Minnesota ond reserving
easements of record,
IND V' z 6 kkL`o
7
/ .,
?
. ...? ?
-... _._?. ?
w
?
a
SIiT FENGL
# 18052
PROPOSED ELEVATIONS
G5 . ?
o?
-- ?
, r a ?.
?45.5 N89°58'2 "E 144.11
95.2 94b.b ? 938A
?---- Qr-- o -- T?---?
?5. 22.00 a lo
Ch/ 9Q7. ?? 26.00 9.3fl.
v1 Sg? o ?'rOfO(Je
o ?g
°?------
Proposed N 2-Story o
9'pcw
4,,09)-
/` 94?.i• N890 I 58'20"E 16yr7-Z 9391
J
LOT SQ. FOOTAGE = 10,261
HSE SQ. FDOTAGE = 1,664
L D T CO I/ERA GE = 16%
PAV'm ME???RIEED
Top of Foundation = 9145.0
Garage Floor = qq7,b
Basement Floor =q39.o
Aprox. Sewer 5ervice =93e.o!
Proposed Elev. _ C=D
Existing Elev. - -
Droinage Directions =-
Denotes Offset Stake = .
SCALE: 1 Inch - 30 feet
- vxnNr-
? 7
=7 ?
o ' Z
0
9
W N I? O
v p
p qO
?
a
o
A
o
, O
y u o
? `c =
o /
m o J
Q
` I
o.v O
1
_ vwcnNr-
BENCHMARK,
C.P'?4013
Ek, = 423 .1.9
MIN. SETBACK REQUIREMENTS
Front - House Side -
Rear - Garage Side-
JOB N0:
HEDLUND I HEREBY CERTIFY THAT THIS IS A TRUE AND CORREC7 REPRESENFATION 01R-521
OF THE BOUNDARIES OF THE ABOV'E DESCRIBED PROPERTY AS SIIRVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PAGE:
PLANNlNC d'NGINBBRINC SURV6YINC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN.
2005 Pin Oak Drive -
Eagan, MN 55122 DATE CAD FILE:
Phone; (651) 405-6600 ? F D. LINDGR , LAND RVEYOR
Fax: (651) 405-6606 MINN SOTA LICENSE NUMBER 14376 Oakbrooke 5
!
ti , 1 ' _
ty e+ E,y-n
-- ?'i iU;
F;,:,,_t•IU'_. ?.3g:,,. ? i:?±`,l:n:
tt):_;i1':'': i•t!Jidi?rY ?J1.'= ?
{';11_; EIWti T t:F' SU.r,c?LY7=c' ii!F:rEIE
a2-i0.YWv U. 00 ,J?I
fil
IpL-d i:;..CPi.pr 'AmfUfiY f.0 'Li
U::?r ?lJgl:?';,IEiI
• MRR-16-2000 10:28 P.02/a2
IMIIQOheck COMPI,IAUICE REBORT
Minnaecta Energy Code
MRdcheck Software veraion 3.0
COIIN'I'Y: DBkcata
STAT3; Min:seaota
ZONE; 2
CONATRUCTSON TYpE: S111g1e Family
DATE: 3-16-2000
DATE OF PLAN9: 3/16f00
TI'1T,E: $pLKIR1C W/D EL. 02
cortPLzAacE: PASSSs
Raquired T,7A = 509
Your Hcme = 407
19.94r eettsr Than Code
Ber C
C ecke y/DaCe
Rxea ox Cavity Cont. Glaziag/DOOs
perimeter R-Value R-Va::.ue II-Value
_-_•-----------------------------------------'------ ^--------
-------------
CETLINGS 1444 44.0 0.0
WAT,;,S: t4ood Frame, 16^ O.C. 2327 19.0 2.0 3.
NALL3: Wood PraA1e, 16° O.C. 283 10,0 2,0
ssMT; coac. 9.01 ht/a.a' bg/9.o, insul ¢oz 21.0 0.0
CT•nZING: Windowe or poosa, Above Grade 485 0.354 1
DC7QRS 38 0.330
FLOORS: 4ver Uncoaditioned 8pace 352 38.0 0.0
HVAC EQVIPMtENT; Furrlace, 92.0 AFC7E
----------- ---------`---------'-------_'_._----------------^^--- ^ .__
COMPLiANCE sTATPMSNT; The propoeed building deeign described here i?s ? ?
caneisteat with the building plana, specificatione, and ether calculations
aubmltted with the parmit applica*_ion. Tha propoeed building ha¢ been
designed to me Mi pa"ota Eneray Code.
Siilder/Desigaer Dace
TOTRL P.02
LOT SURVEY CHECKLIST FOR RESIDENTIAL
BUILDING PERMITAPPLICATION
PROPERTYLEGAL /D'k -? ?cK?d'o, kG
DATE OF SURVEY: l/?a L' D l
LATEST REVISION:
?
?
c
m
cj
DOCUMENT STANDARDS
Y a
O Z a
Q
9Y 0 ? • Registered Land Surveyor signature and company
v? ? • Buiiding PermB Applicant
O ? • Legaldescription
v / ? ? • Address
6/? ? • North arrow and scale
t?'/ ?
[?/ ? ?
? •
• House type (rambler, walkout, split wlo, split entry, bokout, etc.)
Directional drainage arrows with slopeJgradient %
E? ? ? • Propased/exristing sewer and water services 8 invert elevation
fV ? ? • Sheet name
t(! ? ? • Driveway
? ? • LotSquare Footage
? ? • Lot Coverage
Gd ? ? • Benchmark
ELEVATIONS
/ Existin
t5/ ? ? • Sewer service (or Proposed)
GY ? ? • Property comers
?? ? • Top of curb at the driveway and property fine extensans
??? • Elevations af any existing adjacent homes
?[a?/ ? • Adequate footing depth of structures due to adjacent utility trenches
? d ? • Waterways (pond, stream, etc.)
Prooosed
/
?Y/ ? ? • Garage floor
? ? • First floor
? ?
? ? • Lowest exposed elevation (walkouUwindow)
fd
/ ? ? • Property comers
[9' ? ? • Front and 2ar af hame at the foundation
PONDING AREA (iF apolicable)
? ?/ ? • Easement line
0 tr" ? • NWL
? ?/ ? • HWl
? B'?y ? • Pond # designation
? ? • Emergency Overflow Elevatan
l?/ ? ? •
b?"/ ? ? •
fY ? ? •
?
•
? ?
f? •
? ? ? •
DIMENSIONS
Lot lines/Bearings & dimensions
Right-0f-way and street width (ta back of cur6)
Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requirtng pertnanent footings)
Show all easements of record and any City utilities within thase easements
Setbacks of proposed structure and sideyard setback of adjacent existing sWCtures
Retaining wail requiremen- ffany
Reviewed:
Surveyor's Certificate
SURVEY FOR :PULTE HOMES
DESCRIBED AS :Lot 2, Block 3, OAKBROOKE 5TH ADDIION, City ot Eagan, Minnesoto and reserving
easements of record. p?OY ?r ?6 )
ttl 6 151,4IU
r?????
?7
ay 8.0
- w+canr-
J? 995.1 445.5 N89°58'2 "E 144.11
995.2 94b.b 9389 9 l?5 94
? 'y ,-- o--- o ---+?---- -?
I ? 22.00
o ? z
o ' Fa ?
p 9A?. 26.00 p
O
Gorage
9449 h p N? ?saf. ? tio?n O
.i ? Nh/ w c q°
Proposed N Q 4 to o ? O
Y 2-Story o
9'pcw w/o
?
01
? 0 /
N O `" 997. ° 0 0° ? O
26.00
Q
SILT FENG9
N890 I 58'20°E 16T?I? 939.1
-vncnar-
L O T SQ. FO D TA GE = 10,267
HSE SQ. FOOTAGE _ 1,664
L 0 T CO l/ERA GE = 16%
Ixc;F
/j 18052
' r•
PROPOSED ELEVATIONS
Top of Foundation = qqgo
Garage Floor = qqTto
Basement Floor =q39,0
Aprox. Sewer Service =43e.o!
Proposed Elev.
Existing Elev. _
P.M.O.N. RRQURI E=. D
r
BENCHMARK,
C.BW9013
Eku = 923.b9
MIN. SETBACK REQUIREMENTS
Drainage Directions = U Front - House Side -
Denotes Offset Stake = • SCALE: 1 o-,cn = 30 faet Rear - Garage Side-
JOB N0:
HEDLUND I HEREBY CER7IFY THAT THIS IS A 1F2UE AND CORRECT REPRESENTATION 01R-521
OF THE BOUNDARIES OF THE ABOVE DESCRIBED PROPERtt AS SURVEYED
BY ME OR UNDER MY DIRECT SUPERVISION AND DOES NOT PURPORT TO BOOK: PACE:
PLANNlNG BNCIN66RINC SURVEYlNC SHOW IMPROVEMENTS OR ENCROACHMENTS, EXCEPT AS SHOWN.
2005 Pin Oak Orive - - • '
Eogan, MN 55122 DATE -LL/??^/ ? CAD FILE:
Phone: (651) 405-6600 -?LINOGR . LANO VEYOR
Fax: (651) 405-6606 ?--J1MINN SOTA uCENSE NUMBER 14376 OokbfoOke 5
PERMIT# ? -5 --)-- RECEIPTDATE:
2002 RESIDEN'fla+?L PLU14IBI1VH PERMIT APPLICATION
crrY oe EAs,ax
3$30 PILOT KNOB RD
EAfiRN, EiN 55122
651-6$1-4675
Please complete for: single family dwellings, townhomes and condos when permits are required for each unit,
backflow preventer for irrigation system
SITEADDRESS: 04K t4/-Od&=?lca ? P/
OWNER NAME: :ge- TELEPHONE #: 6 57/ 7WY
(AREA CODE)
INSTALLER NAME: c n.? ar..? ga-, TELEPHONE #: ?.SoC ??,?3 5-C,3O
? ?it?,ticau ?/ y{? ? (AREA CODE)
STREET ADDRESS:
CITY: pYo/??i ? STATE: ZIP: ??
I
SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license)
includes $40.00 County fee $ 100.00
Note: Additional consuttant fees may apply
. MODIFICATIONlALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water soReners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water turnaround - existing dwelling unit (+ 5/8" meter if needed -$118)
Other:
RPZ: new installationlrepair/rebuild $ 30.00
?lawn irrigation system JUN 18 1002
ey
ReplacemenUadditional: _ water softener _ water heater $ 15.00
State Surcharge $ 50
rotal $ 1
I herebyacknowledge that I have read this application, statethatthe infortnalion is correct, and agree to complywith all applicabla Cityof Eagan ordinances. It
is the applicani's responsibility to notify the property owner lhat the City of Eagan assumes no liability for any damages caused by the Cityduring its normal
operational and maintenance activities to the §cilities wnstruCed under this permit vilhin City pertylrighb f•yrayT?asep(?nt.
?F+.C
SIOM TURE OF PERMITTEE 1102
PERMIT#
RECEIPT DATE:
SOOE MSIDEPTi!!L PLUM$IAfi PFJM1T lFPPLIClETIOR
crrY oF EAsm
s$so PI.oT KNOB ltD p f? C? ? 0 Crl ?
E.GM.MN 5512E ?
651-691-4675 MAR 14 2002
Please complete for: single family dwellings, townhomes and condos when permits are required for ea unit, p
backflow preventer for irrigation system BY S
SITEADDRESS: v GD odw?
OWNER NAME: : TELEPHONE #: ?l l?' 7 QD Op ??Q
(AREA CODE)
INSTALLER NAME: TELEPHONE #: 5 2 Y ? ?-? (p
STREET ADDRESS: S? q?- UL4404V(- AL (AREA CODE)
CITY: STATE: Md1 ZIP:
_ SEPTIC SYSTEM, new/refurbished (requires two sets of plans and MPC license) $ 100.00
includes $40.00 County fee
Note: Additional consultant fees may apply
• MODIFICATION/ALTERATION TO EXISTING DWELLING UNIT, INCLUDING:
_ Adding fixtures to lower levels or room additions, excluding water softeners and water heaters. $ 50.00
_ Abandonment of septic system.
_ Water tumaround - ewsting dwelling unit (+ 5/8" meter if needed -$118)
Other:
_ RPZ; new installation/repair/rebuild $ 30.00
_ lawn irrigation system
ReplacemenUadditional: _ watersoftener _ waterheater $ 15.00
State Surcharge $ .50
Total $
I herebyadcnowledge that I have read this application, state thatthe information is correct, and agree to complywith all applipble City of Eagan ordinances. It
is the appliranPS responsibility to notlty the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal
operatlonal and mainfenance activitles W tbe tacllities consWcted under this permit within C?iry?o?rry(0Mfof- ayl a?ement.
lw? ? Q V ?
SIGNATURE OF PERMITTEE 7102
A-(,6 0 Yr:E
Site address: L967C 0311,07W? Lot _ Block
Subd.
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be
submitted prior to issuance of a Certificate of Occupancy.
_ This sUucture: is consVucted to meet minimum requirements of the Mn Energy Code, Chapter 7670
x OR
_ This sUucture: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
Water Heater R j p5 .,Z?/S
Furnace a 3` a 1 ?' S Y Ct?D ;.•c_ o t-
Dryer
EXHAUST SYSTEM
LOCATION
TYPE
MODEL
CFM's VENTED
YES No
Kitchen kitchen
Bathroom 7 /Yj?
a • n
r. K4soN.`?.
h V -DS V
Bathroom 2 794 54-
KG$ D-4
F? F- y_ V
Bathroom 3
Bathroom 4
Other
FIREPLACE S
LOCATION
GAS
WOOD
MANUFACTURER
MODEL
BTU'S VENTING
DIRECT AiM05
1J 6- I? CC D 712- 3 7 7 ooa ?
I hereby ackn ledge that the above information is correct and agree to comply with the Minnesota Energy Code and City of Eagan
require enz./?
l,
ignature/7?
f
CompanyName
Z6 Z
Date
This form is the responsibility of the General ConVactor.
Use BLUE or BLACK Ink
I For Office Use I
I I
I Permit City of Ea~a~ D, I
Permit Fee: 191 I
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff:
I I
it-[ 2013 RESIDENTIAL BUILDING/ PERMIT APPLICATION
Date: C`/ 3 Site Address: C(C)g (--3 Unit
Name: Phone:
Resident/
Owner Address /City /Zip: Lc-
Applicant is: Owner Contractor
Type of Work Description of work:
Construction Cost: 1~;r Multi-Family Building: (Yes / No )
I
Company: (/A (A1,1 Contact:
Address: 6 UZ ?U s1 , City: S~
Contractor
State: A41 Zip: q Cr Phone: S v '1 3 v►
License #:I C 6y ~tJ3~ Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)®
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes _No If yes, date and address of master plan:
I Licensed Plumber: Phone:
I
Mechanical Contractor: Phone:
Sewer & Water Contractor: Phone: j
a NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.org
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plarIK"k
Exterior work authorized b a building permit issued in accordance with the Minnesota Sta B ildi g Code must be completed within 180
days of ermit issuance.
X r^
x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA125684
Date Issued:07/30/2014
Permit Category:ePermit
Site Address: 4090 Oakbrooke Alcove
Lot:2 Block: 1 Addition: Oakbrooke 7th
PID:10-53766-01-020
Use:
Description:
Sub Type:Siding & Windows/Doors
Work Type:Replace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of house wrap and leave on site for final inspection.
When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to
ensure maximum ventilation to attic. Call for final inspection after installation.
Valuation: 8,000.00
Fee Summary:BL - Base Fee $8K $162.25 0801.4085
Surcharge - Based on Valuation $8K $4.00 9001.2195
$166.25 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Brett Peterson
4090 Oakbrooke Alcove
Eagan MN 55122
Minnesota Exteriors
8600 Jefferson Hwy
Osseo MN 55369
(763) 391-5514
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA146589
Date Issued:11/02/2017
Permit Category:ePermit
Site Address: 4090 Oakbrooke Alcove
Lot:2 Block: 1 Addition: Oakbrooke 7th
PID:10-53766-01-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Brett Peterson
4090 Oakbrooke Alcove
Eagan MN 55122
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA171039
Date Issued:07/28/2021
Permit Category:ePermit
Site Address: 4090 Oakbrooke Alcove
Lot:2 Block: 1 Addition: Oakbrooke 7th
PID:10-53766-01-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Pete DeGrood at (507)
210-0754.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Brett Peterson
4090 Oakbrooke Alcove
Eagan MN 55122--550
Burnsville Heating & Air Conditioning
3451 West Burnsville Parkway, Ste. 120
Burnsville MN 55337
(952) 894-0005
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA178410
Date Issued:08/16/2022
Permit Category:ePermit
Site Address: 4090 Oakbrooke Alcove
Lot:2 Block: 1 Addition: Oakbrooke 7th
PID:10-53766-01-020
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Brett Peterson
4090 Oakbrooke Alcove
Eagan MN 55122--550
Pcs Residential
2005 Pin Oak Dr
Eagan MN 55122
(651) 994-2028
Applicant/Permitee: Signature Issued By: Signature